THE EFFECTS OF COMBINED EXERCISE WITH AND WITHOUT DIET ON PLASMA INFLAMMATORY BIOMARKERS AND ENDOTHELIAL DYSFUNCTION IN ELDERLY PATIENTS WITH TYPE 2 DIABETES

Background: Inflammation plays an important role in the incidence and development of metabolic disorders and exercises along with dietary restrictions for weight loss. It has beneficial effects on reducing inflammatory markers, especially in type 2 diabetes. The purpose of this study was to evaluate the effect of combined exercise (resistance-aerobic) with and without diet restriction on weight loss on some inflammatory markers (CRP, TNF-α and ICAM-1) in elderly men with type 2 diabetes. Methods: 42 elderly men with type 2 diabetes (age: 67.6 ± 2.2, weight: 85.2 ± 7.4, BMI: 28.2 ± 0.2) after homogenization based on serum levels Glucose and mass index were randomly assigned to one of 3 groups: Combined exercise (15), combined exercise with weight loss diet (14), and weight loss diet alone (n = 13). The combined exercise program included aerobic training with 50-70 percent of reserved heartrate and resistance training included chest press, cable pull-down, machine leg extention and machine lying leg curl on 3 sessions per week for 12 weeks. Results: After 12 weeks of intervention, there was a significant decrease in serum inflammatory markers levels (CRP, ICAM-1 and TNF-α) in the post-test compared to the pre-test in all three groups (P<0.001). However, bonferroni post-hoc analysis showed that combined exercise with diet compared to combined exercise and dietary restriction alone had more effects on reducing CRP, ICAM-1 and TNF-α (P<0.001). In addition, reduction of ICAM-1 (P<0.001) and TNF-α (P<0.001) after combined exercise compared to dietary restriction and CRP reduction after dietary restriction than combined exercise was significantly higher (P<0.001). Conclusion: It suggested that in elderly type 2 diabetic patients, caloric restriction-induced weight loss with combine exercise is more appropriate for modulating of endothelial biomarkers and Inflammation dysfunctional levels than resisted exercise training or aerobic training alone.